Contract Details
Ancillary Care Services
Facility name
Arcadia H.O.M.E.
Provider ID
P000004455
NPI
1407802036
Tax ID
562056348
Effective Date
4/1/2012
Last Updated
10/16/2013
Direct Contract
No
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
76.00
Location Details
Address
46 Boone Trail
North Wilkesboro, NC 28659
United States
County
Wilkes
Phone
3369030111 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address